High prevalence of antimicrobial resistance genes in multidrug-resistant-ESBLs-producing Klebsiella pneumoniae post-COVID-19 pandemic

Golnar  Rahimzadeh; Shaghayegh  Rezai; Ghazal  Abbasi; Saman  Soleimanpour; Reza  Valadan; Laleh  Vahedi; Somayeh  Sheidaei; Faezeh Sadat  Movahedi; Raha  Rezai; Mohammad Sadegh  Rezai

doi:10.18502/ijm.v16i6.17247

Golnar Rahimzadeh Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
Shaghayegh Rezai Department of Medical Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Ghazal Abbasi Students Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
Saman Soleimanpour Department of Medical Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Reza Valadan Molecular and Cell Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
Laleh Vahedi Department of Pathology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
Somayeh Sheidaei Department of Pathology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
Faezeh Sadat Movahedi Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
Raha Rezai Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
Mohammad Sadegh Rezai Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran

DOI: https://doi.org/10.18502/ijm.v16i6.17247

Keywords: Klebsiella pneumoniae; Healthcare associated infections; COVID-19; Extended spectrum beta lactamase; Multidrug resistant; Multiplex polymerase chain reaction

Abstract

Background and Objectives: Klebsiella pneumoniae is a common pathogen associated with healthcare-related infections. It is particularly notable for its ability to develop resistance to multiple antibiotics, making treatment challenging. During the COVID-19 pandemic, increased antibiotic use to manage critically ill patients was contributed to the rise of multidrug-resis- tant Klebsiella pneumoniae. This study evaluated the antibiotic resistance patterns of multidrug-resistant, ESBL-producing Klebsiella pneumoniae in northern Iran after the COVID-19 pandemic.

Materials and Methods: This cross-sectional study was conducted between September 2022 and October 2023. Clinical samples were collected from patients with nosocomial infections at hospitals in Sari. This study included 114 multidrug-re- sistant ESBLs-producing Klebsiella pneumoniae isolates. Antimicrobial susceptibility was assessed using broth macro-dilu- tion, and resistance genes were detected by multiplex PCR.

Results: Gentamicin, ampicillin-sulbactam, co-amoxiclav, and ceftazidime displayed the lowest activity against multidrug-resistant Klebsiella pneumoniae. In contrast, piperacillin-tazobactam showed the highest activity. The prevalence of resistance genes was as follows: bla OqXA -B (67.54%).

Conclusion: This study identified over 50% of antibiotic-resistance genes. Over half of multidrug-resistant Klebsiella pneu- moniae isolates showed resistance to antibiotics except piperacillin-tazobactam, which is recommended for treating multi- drug-resistant Klebsiella pneumoniae infections